Penn Neurologists Report on Promise of Statins, Estrogen and Telemedicine as Potential Targets and Interventions for Parkinson's Disease

PHILADELPHIA — A trio of studies from the Perelman School of Medicine at the University of Pennsylvania demonstrate new approaches to understanding, treating and potentially staving off Parkinson's disease (PD). Studies show that factors such as estrogen exposure and statin use have an impact on the onset of Parkinson's disease. And a new look at telemedicine demonstrates feasibility in providing care for Parkinson's patients using remote video visits to expand access and center care around the needs of Parkinson's patients. These studies and more will be presented at the American Academy of Neurology’s 66th Annual Meeting at Philadelphia’s Pennsylvania Convention Center from April 26 to May 3, 2014.

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"Researchers at Penn Medicine are looking at Parkinson's disease from all angles - ways to improve treatment methods for those currently battling the disease, understanding the root causes of disease, and identifying potential interventions to delay the onset of disease," said Matthew Stern, MD, professor of Neurology in the Perelman School of Medicine at the University of Pennsylvania and director of Penn's Parkinson's Disease and Movement Disorders Center. "We are persistent and eager to find better targets and treatments to help patients with Parkinson's disease, which affects up to 1 million Americans and 10 million people globally." Dr. Stern is the current president of the International Parkinson and Movement Disorder Society.

Statins May Delay Onset of Parkinson's Disease
Research presented by Yosef Berlyand, undergraduate in the laboratory of Alice Chen-Plotkin, MD, MSc assistant professor of Neurology, suggests that statins may be beneficial in Parkinson's disease. In collaboration with Roy Alcalay, MD and colleagues at Columbia University School of Medicine, members of Dr. Chen-Plotkin's research group demonstrated that blood levels of the protein Apolipoprotein A1 (ApoA1) are lower in people with Parkinson's disease than those without disease. PD patients taking statin medications, which can elevate levels of ApoA1, had an older age of disease onset, which appears to be driven by PD patients taking statins. Previous work led by Dr. Chen-Plotkin has suggested that ApoA1 levels may be a new biomarker for PD risk. The team is in the midst of a follow-up study on plasma ApoA1 and statins, evaluating participants in the Michael J. Fox Foundation's Parkinson's Progression Marker Initiative (PPMI) cohort, to confirm whether ApoA1 modifying drugs such as statins may be a promising neuroprotective therapy for Parkinson's disease.

Estrogen Investigated for Protection from Parkinson’s
In another study, an analysis by Kara Smith, MD, a Movement Disorders fellow in Neurology at Penn's Perelman School of Medicine, and colleagues, investigated the role estrogen plays in decreasing lifetime risk of PD, in light of the fact that men have a relative risk of 1.5 of having Parkinson's disease compared to females. In a systemic review of studies using animal models of PD, the team found consistent evidence that 17b-estradiol, in particular, may play a key role in binding to the estrogen receptor and protecting cells from Parkinson's pathology. The team says further research needs to look at 17b-estradiol in more accurate animal models of PD, before results can be translated to clinical trials in people with Parkinson's.

Telemedicine Improves Access to Specialty Parkinson's Care
An additional Penn study being presented at the AAN meeting examined use of telemedicine visits to increase access to specialty care for Parkinson's patients, in an effort to help remove barriers to specialty care experienced by many patients who live far from care or have disabilities that make it difficult to travel. A Penn Medicine team led by Jayne Wilkinson, MD, and Meredith Spindler, MD, conducted a randomized controlled trial using video telemedicine in the patient's home or at a facility near the patient (in this case, Veterans Affairs Medical Centers), connecting them to a neurologist specializing in movement disorders and Parkinson's disease. Early results demonstrate that the process of using telemedicine for Parkinson's specialty care is feasible, provided similar quality of life, care and communication, and significantly decreased travel. This is the largest study to evaluate telemedicine in this Parkinson’s patient population.

The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 18 years, according toU.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $373 million awarded in the 2015 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals byU.S. News & World Report-- Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2015, Penn Medicine provided $253.3 million to benefit our community.